ARCHIVED: Section II: Highlights of Focus Group Discussions: Age-Friendly Rural and Remote Communities: A Guide – Outdoor spaces and buildings

1. Outdoor Spaces and Buildings

The physical environment is an important determinant of physical and mental health for everyone. Creating supportive environments, including age-friendly outdoor spaces and building design, can enhance physical well-being and quality of life, accommodate individuality and independence, foster social interaction and enable people to conduct their daily activities.

Focus group results pointed to what seniors and caregivers identify as important aspects of outdoor spaces and buildings. Older adults and service providers in rural and remote communities expressed that “walkable" sidewalks, pathways and trails are very important for older persons, not only because they support safety and physical activity, but also because they enable older adults to get around and take care of their personal and social needs. Participants also identified the importance of having amenities within close proximity of each other. They identified a number of barriers, including a lack of sidewalks (or continuous sidewalks) in some communities, as well as the dangers of walking and using a scooter on busy streets and highways. Even in communities where sidewalks are common, some participants were concerned with the general state of disrepair and lack of maintenance for both sidewalks and trails.

“A lot of the doors are extremely heavy, very heavy. I've had two falls. I broke my wrist walking on an uneven sidewalk, and then I fell and hurt my shoulder badly. And I have a very hard time opening a very heavy door, and there are several heavy doors to be opened wherever you go."

“I've not been nervous and I mean I've done a lot of walking. In the wintertime I walk with the dog at six o'clock in the morning and it's dark, dark. No, I've never been nervous anywhere—that is the truth."

In addition to the importance of walking for such practical purposes as running errands, walking as a form of physical activity has become increasingly common for older persons. Ensuring that paths, trails and walking routes are supported with sufficient washrooms and rest areas (especially benches) makes these areas more usable by seniors.

Seasonal conditions vary throughout the year and clearly have an impact on the “walkablilty" of communities. Quick and responsive snow-cleaning is appreciated by seniors, although snow clearing can sometimes lead to other problems. For example, snowploughs tend to heap snow along the roadsides which, as several participants noted, can make it difficult for older persons to open car doors blocked by snowbanks.

Buildings with few steps, push-button doors and wheelchair ramps are important for accessibility by all seniors. Aging buildings, however, are often cited as having accessibility problems. More than one participant noted, for example, that older church buildings sometimes have washrooms in the basement, creating a problem for seniors with mobility challenges. In fact, inaccessible washrooms or toilet stalls, stairs and heavy doors were mentioned repeatedly as challenging for older persons.

Overall, the focus group participants expressed that they feel safe and secure in their communities and reported that there is very little crime in their communities. Seniors’ safety and security concerns tend to relate more to worrying about potential accidents, including the fear of falling, which is seen as a limitation to independence and mobility. Similarly, sidewalks or streets that are slippery or have potholes are seen as hazards that make walking unsafe for older adults.

Summary of Key Findings

Results of focus group discussions point to the following highlights with respect to what seniors and caregivers see as important issues and opportunities when it comes to planning for age-friendly outdoor spaces and buildings:

Age-friendly features include . . .

• Walkable sidewalks, pathways and trails
• Good accessibility to and within public buildings (e.g., few stairs, wheelchair ramps that are not too steep, accessible washrooms)
• Along footpaths, accessible washrooms (e.g., wide push-button doors, rails) and rest areas, including benches that are an appropriate height
• Adjustments and adaptations that help seniors feel safe and secure in the community
• Provision of services within walking distance of where many seniors live

Barriers include . . .

• Poor accessibility to and within public buildings
• Lack of and/or poor quality of sidewalks, curbs and crosswalks
• Seasonal factors that reduce walkablility and “scooterability" (e.g., snow, ice)
• Shortage of accessible washrooms and rest areas along walking routes

Suggestions from participants for improving age-friendliness . . .

• Provide intergenerational outdoor activities to foster socialization between younger and older members of the community, and to provide assistance to those with mobility problems.
• Set up indoor walking clubs for periods of poor weather conditions.
• Post signage indicating the location of public restrooms.
• Provide good lighting throughout neighbourhoods and on trails.

2. Transportation

Whether driving a car or taking public or private transportation, access to transportation allows seniors to participate in social, cultural, volunteer and recreational activities, as well as enabling them to carry out such daily tasks as working, shopping or going to appointments.

The majority of seniors who participated in the focus groups reported that they own and drive a car. Good roads, light traffic flow, prompt snow removal and generally adequate parking options were among the positive aspects of driving in rural and remote communities mentioned by older persons. However, a lack of parking for people with a disability (“handicapped" parking stalls) and the failure of local authorities to monitor their use was a commonly identified barrier. In addition, poor road signage, poor road design, and poor enforcement of traffic and parking laws—were seen by seniors as compounding factors.

“Now that I'm getting older, and I am old, I should say, I know that one day they're going to say, ‘Well, no more licence for you.’ That's going to happen to all of us."

Seniors also expressed concerns about their future as older drivers and many feared the loss of independence that would come with giving up their licence.

Unlike city-dwellers, seniors living in rural and remote areas are much less likely to have access to a range of public and other types of transport. In fact, some communities have no form of public or private transportation. In communities where there is a public transportation system, however, it often does not meet the needs of older persons. For example, seniors often have different travel patterns than others who use public transportation—they may travel outside the peak (work) hours and use it for different reasons, such as visiting friends, participating in activities, accessing services and going shopping. Public transportation, if it is available, may not be geared to such needs and timing. The resulting low ridership often leads to the reduction or cancellation of services.

Older adults with mobility issues or disabilities also often have difficulty using public transportation for a number of reasons. For example, fixed schedules may not be sensitive to their needs, and pedestrian accessibility (sidewalks, etc.) may be poor. Seniors who do not own a car are particularly at risk for social isolation, and may also experience difficulties in accessing community and medical services. The lack of public transportation (or a convenient alternative) was identified by service providers as the reason for seniors continuing to drive for longer than was safe to do so.

Participants identified options and approaches that work well in their communities—notably, the availability of vans or shuttles, many operated voluntarily and/or with the assistance of government subsidies, as well as programs that transport older persons to the larger centres for health-related appointments. Such programs are becoming increasingly necessary, providing a key advantage to older persons. Moreover, where they are in place, they tend to be well used by seniors. Availability of taxi service is seen as important by seniors.

“We have two handi-vans—one is wheelchair accessible, the other one is just for people that need to be transported and are not in a wheelchair. It works wonderfully well.”

“We all agree here we do need transportation and friends are fine, family are fine, but they can only go so far.”

“I do have an elderly mother who relies on other people for her back-up, and after you've made five phone calls—you're desperate. And you're so sad about at having to be dependent on someone else to do that for you.”

The focus group results point out that, even in the smallest communities, many older persons are not aware of the transportation options available. In other cases, even if they are aware that such services exist, they lack details about cost, hours of operation and who is eligible to use them.

Results also show that, by far, transportation provided by family members (in particular, daughters), friends and neighbours is the most common and frequently used transportation option. One service provider referred to neighbours and volunteers as the "underground public transportation taxi system," noting that they readily give of their time. The same person commented that rising gas prices are becoming prohibitive for these voluntary drivers.

As one caregiver’s comment illustrates, however, the costs go beyond that of the price of gas. The real cost of this "underground" transportation system is the discomfort older persons have with their dependence on others to get around the community and beyond—a loss of both their independence and their pride. Several participants also raised a critical question: what do people without family members or helpful neighbours do?

The issue of transportation came up as a dominant issue in most other themes discussed in the focus groups—housing, social inclusion and participation, and, in particular, community support and health services.

Summary of Key Findings

Focus group discussions highlighted the following issues, needs and suggestions for communities to consideration with respect to transportation:

Age-friendly features include . . .

For older drivers

• Good roads, light traffic flow
• Prompt snow removal
• Adequate parking

For older people using public transportation

• Volunteer drivers and/or informal networks that provide transportation services
• Vans or shuttles available for seniors
• Health transportation services (including to larger centres)
• Assisted transportation available (with wheelchair lifts)
• Affordable and accessible taxis

Barriers include . . .

For older drivers

• Parking difficulties or lack of loading/unloading areas
• Other drivers, timing and traffic issues
• Lighting and other visibility problems

For older people using public transportation

• Over-reliance on family, friends and neighbours to provide transportation services
• Lack of options—no buses or taxis
• The expense to travel outside of the community
• Poor scheduling or connectivity
• Lack of accessibility
• Lack of information about transportation options
• Underutilization of services (e.g., public buses, dial-a-ride, handi-vans) that result in their cancellation because of low ridership

Suggestions from participants for improving age-friendliness . . .

For older drivers

• Make driver refresher courses available to people over age 50.
• Offer a "limited driver’s licence" for those who may otherwise lose their licence allowing, for example, driving during daylight hours, or within a five-mile radius of home.
• Designate parking spots for people with health problems that limit mobility (i.e., for those who cannot walk very far) but who do not qualify for a disability sticker.

For other transportation

• Provide a taxi service that operates on a specific route, stopping at two or three places several times a day—and consider subsidizing such a service to make it economically feasible and accessible to older people.
• Provide more frequent public transportation service at night and in winter.